使用联合分析评估男男性行为者中进行HIV检测的意愿,FDA批准的家用HIV检测的采用证据。

Assessing willingness to test for HIV among men who have sex with men using conjoint analysis, evidence for uptake of the FDA-approved at-home HIV test.

作者信息

Lee Sung-Jae, Brooks Ronald, Bolan Robert K, Flynn Risa

机构信息

a Department of Psychiatry and Biobehavioral Sciences , UCLA Semel Institute - Center for Community Health , Los Angeles , CA , USA.

出版信息

AIDS Care. 2013;25(12):1592-8. doi: 10.1080/09540121.2013.793272. Epub 2013 May 7.

Abstract

Men who have sex with men (MSM) in the USA, represent a vulnerable population with lower rates of HIV testing. There are various specific attributes of HIV testing that may impact willingness to test (WTT) for HIV. Identifying specific attributes influencing patients' decisions around WTT for HIV is critical to ensure improved HIV testing uptake. This study examined WTT for HIV by using conjoint analysis, an innovative method for systematically estimating consumer preferences across discrete attributes. WTT for HIV was assessed across eight hypothetical HIV testing scenarios varying across seven dichotomous attributes: location (home vs. clinic), price (free vs. $50), sample collection (finger prick vs. blood), timeliness of results (immediate vs. 1-2 weeks), privacy (anonymous vs. confidential), results given (by phone vs. in-person), and type of counseling (brochure vs. in-person). Seventy-five MSM were recruited from a community-based organization providing HIV testing services in Los Angeles to participate in conjoint analysis. WTT for HIV score was based on a 100-point scale. Scores ranged from 32.2 to 80.3 for eight hypothetical HIV testing scenarios. Price of HIV testing (free vs. $50) had the highest impact on WTT (impact score = 31.4, SD = 29.2, p<0.0001), followed by timeliness of results (immediate vs. 1-2 weeks) (impact score = 13.9, SD = 19.9, p≤0.0001) and testing location (home vs. clinic) (impact score = 10.3, SD = 22.8, p=0.0002). Impacts of other HIV testing attributes were not significant. Conjoint analysis method enabled direct assessment of HIV testing preferences and identified specific attributes that significantly impact WTT for HIV among MSM. This method provided empirical evidence to support the potential uptake of the newly FDA-approved over-the-counter HIV home test kit with immediate results, with cautionary note on the cost of the kit.

摘要

在美国,与男性发生性行为的男性(MSM)是一个艾滋病毒检测率较低的弱势群体。艾滋病毒检测有各种特定属性,可能会影响艾滋病毒检测意愿(WTT)。确定影响患者艾滋病毒检测意愿决策的具体属性对于提高艾滋病毒检测率至关重要。本研究采用联合分析方法来研究艾滋病毒检测意愿,联合分析是一种系统评估消费者对离散属性偏好的创新方法。在八个假设的艾滋病毒检测场景中评估了艾滋病毒检测意愿,这些场景在七个二分属性上有所不同:检测地点(在家中与在诊所)、价格(免费与50美元)、样本采集方式(手指采血与静脉采血)、结果及时性(即时出结果与1-2周出结果)、隐私性(匿名与保密)、告知结果方式(通过电话与当面)以及咨询类型(提供宣传册与当面咨询)。从洛杉矶一家提供艾滋病毒检测服务的社区组织招募了75名男男性行为者参与联合分析。艾滋病毒检测意愿得分基于100分制。八个假设的艾滋病毒检测场景的得分范围为32.2至80.3。艾滋病毒检测价格(免费与50美元)对检测意愿的影响最大(影响得分=31.4,标准差=29.2,p<0.0001),其次是结果及时性(即时出结果与1-2周出结果)(影响得分=13.9,标准差=19.9,p≤0.0001)和检测地点(在家中与在诊所)(影响得分=10.3,标准差=22.8,p=0.0002)。其他艾滋病毒检测属性的影响不显著。联合分析方法能够直接评估艾滋病毒检测偏好,并确定了对男男性行为者艾滋病毒检测意愿有显著影响的具体属性。该方法提供了实证证据,以支持新获得美国食品药品监督管理局批准的即时出结果的非处方艾滋病毒家庭检测试剂盒的潜在采用率,但需注意该试剂盒的成本。

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